<html>



<head>

<style type="text/css">
<!--
#apDiv1 {
	position:absolute;
	left:323px;
	top:153px;
	width:514px;
	height:36px;
	z-index:1;
}
-->
</style>
</head>


<body>
<p align="center"><img src="cabecera.jpg" alt="" width="590" height="24" /></p>
<p align="center">&nbsp;</p>
<table width="186" border="1" align="center">
  <tr>
    <td width="85">Usuario</td>
    <td width="85"><label>
      <select name="select" id="select">
        <option>Ruben</option>
        <option>Burro</option>
      </select>
    </label></td>
  </tr>
  <tr>
    <td>Equipo</td>
    <td><select name="select2" id="select2">
    </select></td>
  </tr>
  <tr>
    <td>Fecha alta</td>
    <td><label>
      <input type="text" name="textfield" id="textfield" ">
    </label></td>
  </tr>
  <tr>
    <td>Fecha baja</td>
    <td><input type="text" name="textfield2" id="textfield2"></td>
  </tr>
  <tr>
    <td>Estado</td>
    <td><select name="select5" id="select5">
    </select></td>
  </tr>
</table>
<p align="center">
  <label>
  <input type="submit" name="button" id="button" value="Enviar">
  </label>
  <input type="reset" name="button2" id="button2" value="Borrar">
</p>
<p align="center">&nbsp;</p>
<p>&nbsp;</p>
<p align="center"><img src="pie.jpg" alt="" width="590" height="24" /></p>
</body>


</html>